Adequate salivary secretion is crucial to both oral and general health, since it provides
a complex milieu for support of the microbial populations of the mouth, while at the same
time containing antimicrobial products that help control these microbial populations. This
paper summarizes several aspects of salivary component function, gland secretion
mechanisms, and immuno-pathogenesis as related to oral health and disease. Salivary
components mediate microbial attachment to oral surfaces, and also interact with
planktonic microbial surfaces to facilitate agglutination and elimination of pathogens
from the oral cavity. Adhesive interactions are often mediated by lectin-like bacterial
proteins that bind to glycan motifs on salivary glycoproteins. An important salivary
antimicrobial protein is histatin 5 (Hst 5), which shows potent and selective antifungal
activity and also susceptibility to proteolytic degradation. Coupling of Hst 5 with the
carrier molecule spermidine significantly enhanced killing of C.
albicans and resistance to proteolytic degradation, compared with the parent
peptide. Loss of salivary secretion may be caused by disorders such as Sjögren's syndrome
(SS) or ectodermal dysplasia, or may be a side-effect of radiation therapy. Two new
approaches to the treatment of salivary gland dysfunction include the use of resolvins and
the creation of differentiated acinar structures to construct an artificial salivary
gland. B-cells contribute to the pathogenesis of SS by releasing cytokines and
autoantibodies and by influencing T-cell differentiation. CXCL13, a potent B-cell
chemokine associated with autoimmune diseases, is elevated locally and systemically in SS
and may represent a novel biomarker or therapeutic target in the management and treatment
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